tetano
Editor, Senior Moderator
ur Heart J Case Rep
. 2021 Nov 8;5(12):ytab454.
doi: 10.1093/ehjcr/ytab454. eCollection 2021 Dec.
Ventricular fibrillation arrest due to Brugada syndrome in a coronavirus disease 2019 patient with negative procainamide challenge: a case report
Guangchen Zou[SUP] 1 2 [/SUP], Mukul Khanna[SUP] 3 [/SUP], Saliha Zahid[SUP] 1 2 [/SUP], Samir Dengle[SUP] 3 [/SUP], Bhavna Matta[SUP] 1 2 [/SUP], Haris Zaheer[SUP] 1 2 [/SUP], Matthew Farrell[SUP] 4 [/SUP], Russell Stein[SUP] 3 [/SUP]
Affiliations
Abstract
Background: Pharmacologic challenge test is often used to diagnose Brugada syndrome (BrS) when spontaneous electrocardiograms (ECG) do not show type I Brugada pattern but reported sensitivity varies. The role of the exercise stress test in diagnosing Brugada syndrome is not well-established.
Case summary: A patient had a type I Brugada pattern ECG during the recovery phase of exercise stress test but had a negative procainamide challenge test. He had a loop recorder implanted and later survived a ventricular fibrillation (VF) arrest provoked by coronavirus disease 2019 (COVID-19). Electrocardiogram on arrival showed type 1 Brugada pattern. He was discharged after implantable cardioverter-defibrillator implantation. He later underwent genetic testing and was found to be heterozygous for c.844C>G (p.Arg282Gly) mutation in the SCN5A gene.
Discussion: Type 1 Brugada pattern ECG may be unmasked by ST-segment augmentation during recovery from exercise. Exercise stress test may play a role in the diagnosis of Brugada syndrome when suspicion for Brugada syndrome remains after a negative procainamide challenge test or if the patient has exercise-related symptoms. COVID-19 can unmask BrS and trigger a VF cardiac arrest.
Keywords: Brugada syndrome; COVID-19; Case report; Exercise stress test; Procainamide challenge; Ventricular fibrillation.
. 2021 Nov 8;5(12):ytab454.
doi: 10.1093/ehjcr/ytab454. eCollection 2021 Dec.
Ventricular fibrillation arrest due to Brugada syndrome in a coronavirus disease 2019 patient with negative procainamide challenge: a case report
Guangchen Zou[SUP] 1 2 [/SUP], Mukul Khanna[SUP] 3 [/SUP], Saliha Zahid[SUP] 1 2 [/SUP], Samir Dengle[SUP] 3 [/SUP], Bhavna Matta[SUP] 1 2 [/SUP], Haris Zaheer[SUP] 1 2 [/SUP], Matthew Farrell[SUP] 4 [/SUP], Russell Stein[SUP] 3 [/SUP]
Affiliations
- PMID: 34909573
- PMCID: PMC8664766
- DOI: 10.1093/ehjcr/ytab454
Abstract
Background: Pharmacologic challenge test is often used to diagnose Brugada syndrome (BrS) when spontaneous electrocardiograms (ECG) do not show type I Brugada pattern but reported sensitivity varies. The role of the exercise stress test in diagnosing Brugada syndrome is not well-established.
Case summary: A patient had a type I Brugada pattern ECG during the recovery phase of exercise stress test but had a negative procainamide challenge test. He had a loop recorder implanted and later survived a ventricular fibrillation (VF) arrest provoked by coronavirus disease 2019 (COVID-19). Electrocardiogram on arrival showed type 1 Brugada pattern. He was discharged after implantable cardioverter-defibrillator implantation. He later underwent genetic testing and was found to be heterozygous for c.844C>G (p.Arg282Gly) mutation in the SCN5A gene.
Discussion: Type 1 Brugada pattern ECG may be unmasked by ST-segment augmentation during recovery from exercise. Exercise stress test may play a role in the diagnosis of Brugada syndrome when suspicion for Brugada syndrome remains after a negative procainamide challenge test or if the patient has exercise-related symptoms. COVID-19 can unmask BrS and trigger a VF cardiac arrest.
Keywords: Brugada syndrome; COVID-19; Case report; Exercise stress test; Procainamide challenge; Ventricular fibrillation.